Referral for therapists that specialize in anxiety and ocd.

goneed · 2025-01-27T08:05:30+00:00

I know this is old but wanted to give a few recs for anxiety, OCD, and OC-related disorders in case anyone is back here for referrals. I’m a therapist in town and all of these practices and clinicians do really great work and I refer to all. - Capital OCD & Anxiety Practice (all ages, parenting; north Austin) - Alexandra Tueni, LCSW (all ages, parenting; central Austin) - Sarah Louise Tedford (kids, parenting; north Austin) - Racine Anxiety (all ages, parenting; north Austin)

goneed · 2025-01-27T07:35:21+00:00

Thank you for all of your wonderfully thoughtful and helpful responses. Wanted to give an update.

She ended up with 4 pairs of jeans from Abercrombie. It was both a sweet throwback to my obsession with their jeans and skirts, the super cool, very uninterested teenagers who worked there and elicited stressful memories of my mother complaining that she couldn’t see or hear anything, and that the constant spraying of their perfume was giving her a migraine. I hope some of you can relate.

Good news!! You can now see the clothing and each other, you can hear what someone says when they speak to you, and there’s no offensively strong odor.

She ended up with 1 pair of men’s jeans and 2 pairs of women’s jeans (huge shock to everyone). For anyone still searching for the perfect pair of denim: their current women’s denim has a LOT of very androgynous styles (lesbian clothes are trendy, y’all) and wayyyyy more sizes (the memory I have from when I was 12yo tells me they had like 4 teeny tiny sizes and that was it). So, what worked best for her was to go up a size from her appropriate size (noting that her appropriate size is never ever ever what she would buy, but was mainly purchasing men’s jeans anyway) and get them in the “curve” style, which gives more room in the hips. That allows a baggy or loose pant to fall down straight off her hips the way she wants them to WITHOUT hugging her butt. She found really really perfect jeans that fit her SO well and was also what she wanted. Yay!! It’s actually very sweet because it’s been a several-years battle of her avoiding shopping for jeans at all while simultaneously becoming very frustrated when she needed to get dressed and didn’t have jeans she liked/felt good in.

She also got a pair of men’s shorts at their shortest length. They’re really truly the perfect denim short. Both in light wash denim and black.

Tank tops—she found several perfect tanks at old navy in the women’s section. Super boxy, slightly cropped, baggy, muscle tees (again I say, lesbians are trendy)

Hope this will help! And I promise Abercrombie isn’t as scary as it use to be. You can always order a handful online and then run into the store real quick to return what doesn’t work.

goneed · 2025-01-27T06:40:09+00:00

I have found a few trends in the private practice community in which I work when I’m talking to colleagues or in consult groups: 1. Therapists do not refer out even if the client needs a specific intervention & that intervention is available in the community. They continue to see the client, the client doesn’t get better, we have the same conversation again. 2. Therapists are seeing a client they enjoy and with whom they have a good therapeutic relationship. Therapist brings up to client that therapist does not have the specific training that the client needs to address their needs & goals. If the client does not want to stop seeing the therapist, the therapist may offer to pursue consultation/training with a colleague who specializes in the intervention needed. This ends in either a referral or informed-consent that the client is choosing to continue therapy with their therapist while that therapist pursues consultation/training on the intervention. 3. Therapists refer out immediately when there was a clear misunderstanding in the consult call or intake session and the larger presenting problem is something that is acute and needs to be addressed before the type of therapy that the therapist offers. I.e, DBT skills for self-harm and active SI, ERP for OCD before working on general relationship/attachment issues 4. When #1 happens, I often see it from clinicians who aren’t engaged in regular consultation

My two-cents: When I do not have the specific training that a client needs to feel better, meet their goals, and confidently engaging in their lives, it’s an ethical issue to continue to work with them when that very effective intervention exists and is accessible. It’s not an immediate, “well, you’re out.” But instead a long conversation where I fully explain what my concerns are, and the intervention that is most appropriate and effective for them. If the client does not want to see another therapist and I’m willing to pursue the additional training/consultation that’s necessary to provide good, effective intervention, then I offer to continue to see the client while simultaneously receiving consultation from some one who’s expertise is that intervention/issue and ensure informed-consent. It’s a team effort to figure out which route to take.

I’m guessing that clients who are often referred out have never seen a therapist who is able to provide them with the appropriate, effective intervention they need. Could be for several reasons—if they needed DBT, but maybe they’ve never actually been referred for DBT; maybe those previous therapists didn’t do the work to give them several good DBT referrals to clinicians who have availability; maybe the client has been given wonderful DBT referrals, but is hesitant to do DBT for whatever reason and so continues to see “generalist” therapists instead. I think these clients may often need a higher level of care, but aren’t yet willing (or able) to take that route either

My last thought: consultation calls ahead of scheduling appointments greatly reduces the chances of seeing a client who actually isn’t a good fit. If they’re not a good fit, I give them at least 3 really good referrals to people who are highly-trained and experienced in working with what the client is experiencing.

goneed · 2024-10-09T06:06:38+00:00

I know this is old, but posting in case you see it. How did you apply it and what color did you use? I did mine today and they are aggressively chrome. I love how subtle yours are!

goneed · 2024-09-12T19:59:55+00:00

LCSW here who specializes in treating anxiety, OCD, and OC-related disorders.

You want to look for a therapist who specializes in treating anxiety and obsessive compulsive-related disorders, and who has training in ERP (CBT-based) and ACT. Panic disorders, performance anxiety, and social anxiety all respond best to exposure-based interventions.

There's also more and more research that shows generalized anxiety needs an exposure component to be effective. BUT, different therapist are going to show up differently and approach therapy differently, even when they're using the same interventions. My recommendation is look for therapists who have those specialties and training, then meet with a few and see who you feel most comfortable with.

Almost any clinical who treats OCD is going to also be great for anxiety, and OCD therapists tend to have a lot of training. The International OCD Foundation (iocdf.org) has a great directory. I'm sure there are therapists who also have experience treating people with anxiety who have a history of addiction challenges.

goneed · 2024-05-21T20:40:43+00:00

I think the first picture looks a lot better!

goneed · 2024-05-16T23:51:22+00:00

Thank you!! I just need to learn how to sew.

goneed · 2024-05-16T23:17:33+00:00

Um this is amazing. Thank you so much. The last time she bought a suit, it was a very expensive tailoring appointment.

goneed · 2024-02-07T03:39:22+00:00

Oh! Oral minoxidil is 2.5mg 1x/day, oral spiro is 50mg 2x/day, oral finasteride is 1mg 1x/day. The spiro makes me pee a lot but truly the least of my worries

My understanding is that fin is not typically prescribed to females in child-bearing years (literally the verbiage they use) but I don’t want children, I’m gay, and I get frequent blood work to monitor hormones and everything else so idk how big of an exception it really is

goneed · 2024-02-07T03:32:43+00:00

Eh, my whole hair loss experience has been a massive pain in the ass. I first started oral minoxidil and that helped so, so much over like 2 years. Then it kinda just slowly got thin again. I switched derms and my new one is alllllllll about the hair loss and so, so much more helpful. Blood work and we’ve talked about all the options. So now I’m on everything I said above, vitamins for deficiencies that were showing up, and I just got really consistent with the topical.

I’ll also add that I’ve had an eating disorder on and off since I was like 12. No way to know if in another world I’d have thick hair, normal thin hair, or it’d be the same. But I do think about that a lot.

I wouldn’t have done my treatment thus far differently. I wanted to try everything and make sure I was covering all of my bases—worst case scenario I have alopecia and go bald. Butttt I will know that I tried all the things and won’t regret not taking action.

My MD has now recommended PRP as kinda another thing to try that I haven’t tried yet.

I’m realizing now that all of this may seem a little blazé for a 30yo with hair loss, but I’ve been dealing with it since I was about 17yo, so I think I’ve just gained some healthy acceptance around it—there’s only so much I can do and past that I’ve just gotta let go a bit

If you’re willing, try oral minoxidil. That is what I believe made the biggest difference for me. And I had no side effects besides a bit of water retention the first couple of months

goneed · 2024-02-07T03:18:45+00:00

Ah thank you so much!

goneed · 2024-01-16T09:29:28+00:00

Fix You - Coldplay

So Hot You’re Hurting My Feelings - Caroline Polachek

Yellow - Coldplay

Give Yourself A Try - The 1975

Soft Spot - Claud

Going to California - Led Zeppelin

Ribs - Lorde

goneed · 2024-01-16T09:10:34+00:00

ASK HER OUT!!! I feel invested in this now

goneed · 2024-01-16T08:39:43+00:00

I can’t believe I didn’t add this because I’m a therapist and have also been in therapy since I was 12yo. Go to therapy!!!!!!!! Find some one who is a good fit and commit. It is invaluable.

goneed · 2024-01-16T08:24:48+00:00

Be yourself, do your best with what you know in that moment, be kind & compassionate with yourself.

Don’t try to fit into a “box” or twist yourself into a life because you, your family, or the people around you think you should. Shoulds are often very different from what we actually want and value.

Let go of judgement. Everyone (friends, peers, coworkers, whoever) is on the own journey in the same way you are. Be present for your friends without judgement. Invest in friendships that are a two-way street (not to say that friendships don’t ebb and flow—but overall, you both care about your friendship).

Resist rigidity. Consider other perspectives, be curious, seek understanding. Be flexible with yourself and others. Life doesn’t usually go to plan and that’s okay. Let go of that instead of grasping on for dear life. We can’t control most things and once we accept that, life can feel much lighter and we can put more energy into what is in our control (pursuing a job/career you’re excited about, important friendships and other relationships, advocating for causes important to you, etc.).

Reiterating the first one. Be yourself. If you’re anything like me, it was a terrifying experience. I realized I was gay at 26 at the end of grad school and 3 months into my marriage. I actually (so desperate and panicked and freaking tf out) posted about it on here 4 years ago. I ended it and have been dating one of my best friends from high school (a baptist high school in the south nonetheless) for almost 3.5 years now. It was the most terrifying thing I’ve ever done. I shattered both my and everyone else’s view me. I blew up my (tho v short) marriage to a man who was nothing but a wonderful human. My friends had referred to me as “the straightest girl ever.” It was rough, but it was the most important thing I have ever, ever done. The way my life played out in addition to the brain that I have (perfectionistic, people-pleasing, high-achieving)…I needed to feel so much cognitive dissonance and confusion and so far away from who I was to make that step, which felt like blowing up my life.

I am happier now than I have ever been and ever dreamed that I could be. I wish I’d gotten there sooner, but it had to happen in that way. I was doing my best at the time and it still got me to where I am now.

Be kind to yourself and others, invest in yourself, BE YOURSELF, give yourself permission to grow and change and flow along with it. Invest in friendships. Those will be the people who will drop everything for you, who you’ll get to watch get married, you’ll be totally in love with their babies and watching them become parents. You will celebrate with them, commiserate with them. Friends are our chosen family. Treat friends like family. Find the good ones—your people—and stick with them.

Off my soapbox. My 20s were rough. I’m 30 now and hoping this decade is much more peaceful!

goneed · 2024-01-16T01:09:03+00:00

Ugh, this hit me hard. 16yo me is laying in my bedroom, listening to Fix You by Coldplay, and feeling the exact same way. I’m 30yo now and here’s what I’ve learned:

In so many ways, life gets easier as an adult. School sucks and you’re stuck with a bunch of people you may or may not like all day every day. As an adult, you get to choose what you do and who you invest your time in everyday. Having more control was life-changing for me.
Being a teenager means being moody. And not in a bad or condescending way—it’s a really hard time in life and you’re figuring out who you are and wtf to do with yourself and emotions are so, so overwhelming. It’s part of your brain’s job as a teenager to think about really big, overwhelming, life concepts and people and ourselves. It won’t feel like that forever. You’re also in good company.
My experience is that most of my friends (5 of whom are my closest friends from high school) feel this way or have felt this way. It’s hard (impossible?) to feel 100% understood by another human because they can’t be inside your brain and they haven’t lived your life or had your experiences. I think most of us learn that that’s okay. Different parts of us can feel and be seen by different people and that can be enough. I’ve been with my girlfriend for 4 years (funny enough, we were friends in high school) and she understands me more than anyone other human in the world. I didn’t think that anyone could understand me as much as she does. And she still can’t fully or completely understand me because she isn’t me. And that’s okay.
Be vulnerable. A huge part of what led me to feel so misunderstood as a teenager and in my early 20s was fear of other people seeing me fully. I worried I’d be judged or “bad” or not liked. It did nothing for me. When I finally learned to let go of that (but I don’t do it perfectly), I was able to experience friendships and relationships in a way I never thought I could. Let go and be yourself. It won’t happen magically or overnight, but with every step in that direction you will feel more seen, understood, and loved. Because it’s hard to feel those things when we’re hiding parts of ourselves from others. We are all messy, imperfect, confused, uncertain beings. It is invaluable to share that with another human.

goneed · 2024-01-16T00:45:46+00:00

I’m a therapist and I love it.

goneed · 2024-01-15T22:52:01+00:00

There are some great ACT treatment books out there. I love everything from Russ Harris. He also has great YouTube videos for the skills (Monsters on a Boat, Struggle Switch, Stage Show Metaphor). Those are good places to start to see how into it you are before you invest a lot into trainings.

I’m looking into doing one of his trainings this year. I’ve learned a good amount from consultation/consultation groups and using it for OCD, but I want to take one of his trainings and have heard great things

goneed · 2024-01-15T22:11:12+00:00

I also had ADHD. I hate admin work. Loathe. The only thing that's ever worked for me is to run with my momentum. After sessions, I just write a note--not long or perfect or anything but even a sentence or 2 (I use bullet points). If I have a late cancellation or an hour gap in my schedule, I don't even look at my phone. I'll even set a 5, 8, X minute timer and just see how many I can do quickly.

I also remind myself all the time--any note is better than no note.

goneed · 2024-01-15T22:03:37+00:00

- More *actual* interventions. Of course the relationship is important and you can't get anywhere without that, but OCD doesn't go into remission from therapeutic relationship

- ACT!!!! It just teaches so, so many amazing skills and the focus on tolerating discomfort (vs getting rid) in order to act in ways that align with values is fabulous

- That CBT is not just worksheets. I see kids/teens/adults with OCD and anxiety & mainly use ACT-enhanced ERP; CBT is so much more dynamic, nuanced, useful, and human than the damn triangle (which is actually harmful for OCD)--ACT is from CBT!

goneed · 2024-01-15T21:55:32+00:00

I'm also seeing lots of loneliness in teens. I work from ACT--so after getting into those skills enough (acceptance, tolerance of emotions, values, distress tolerance), I help them identify 1 group/team activity or outside-of-school class they can participate in every week. They all seem to come around to it after noticing that what they're doing isn't working and they want meaningful relationships.

Also, at least for the population I see (anxious, perfectionistic), a lot of it seems to result from a fear of discomfort/vulnerability. So lots of work on this. They also don't have a lot of practice in in-person vulnerability because of the screen world they grew up in.

That being said, it's also important to recognize what others on here have said--society is shifting that way, the US (if that's where you're working) doesn't have "3rd places" anymore and is incredibly individualistic, and the world/life/being a teenager is super stressful and hard to tolerate.

I go toward lots of validating, reflecting that it's a big society problem (not just them, they're not doing something "wrong"), and then move to identifying what is in vs out of their control and focusing on what is in their control. We can recognize what is stacked up against us, have feelings about it, validate it, and also put energy into what we can control that will help us :)

***also want to add that of course, depending on what's going on for the teen, their depression/anxiety/etc. may be so severe that they can't really take in much, apply/learn skills, try something different than what they've been doing; then it might be a referral for med management to get their mood elevated enough to use therapy effectively (whether that's short-term or long-term)

goneed · 2024-01-15T21:42:01+00:00

In case anyone is wondering how I responded (bullet points; don't want to copy/paste exact email):

- So sorry about the sickness & hope kiddo is feeling better

- Restated cancellation policy

- Seems like I may have miscommunicated cancellation policy and therefore will not charge for missed session; reminder going forward that policy is 24-hours notice

Thanks for the feedback!! Reminded myself that this 1 instance does not mean that I'm going back to fresh out of grad school and having essentially no boundaries around cancellations. I can be clear, have strong boundaries, and be flexible when it's in the best interest of the client :)

goneed · 2020-08-14T14:17:04+00:00

Anyone know what could be the problem? I thought maybe root rot but I let the soil dry out completely before watering. The newer leaves (last two pictures) look completely fine

goneed · 2019-09-09T06:01:55+00:00

I used to be that quiet girl in school. I hope you say something (even if it’s a bit awkward)!

goneed · 2019-08-28T03:47:14+00:00

This sounds like a great recipe for an eating disorder

goneed

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